How would you approach a patient with a locoregional recurrence TNBC who requires neoadjuvant treatment?

My assumption is that the patient developed this currently unresectable LRR after completing neoadjuvant chemotherapy and surgery, and has to be considered at high risk for both local complications, which is why you want to administer 'neoadjuvant' therapy (although I'm not sure that the term is applicable to this setting) and development of metastatic disease. This is a very challenging situation.

I would test the patient's cancer for PD-L1 expression, preferring to send her initial biopsy as opposed to a biopsy of her recurrence, since we have less data on the predictive value of PD-L1 expression in recurrent/metastatic disease on the potential value of chemo/immunotherapy with nab-paclitaxel and atezolizumab. If her tumor is PD-L1 positiv...